,Geriatric Nursing Certification Prep: 800+
Questions for Advanced Practice Nurses
📘 Table of Contents
Unit I: The Healthy Older Adult
1. Changes with Aging
2. Health Promotion
3. Exercise in Older Adults
4. Nutritional Support in the Older Adult
5. Settings of Care (new chapter in this edition)
Unit II: Assessment
6. Comprehensive Geriatric Assessment
7. Symptoms and Syndromes (covers common geriatric
syndromes and their atypical presentations)
Unit III: Treating Disorders
(Returns to system-based chapters with signal-symptoms, SORT
evidence ratings, in-text case studies)
8. Dermatologic Disorders
9. Head, Neck, and Face Disorders
10. Cardiovascular Disorders
11. Respiratory Disorders
12. Peripheral Vascular Disorders
13. Gastrointestinal Disorders
,14. Urologic and Renal Disorders
15. Gynecologic Disorders
16. Musculoskeletal Disorders
17. Central and Peripheral Nervous System Disorders
18. Endocrine and Metabolic Disorders
19. Hematologic Disorders
20. Psychosocial Disorders
Unit IV: Complex Illness
21. Polypharmacy
22. Chronic Illness and the APRN
23. Palliative Care and End-of-Life
,Chapter 1 “Changes With Aging” from Advanced Practice
Nursing in the Care of Older Adults, 3rd Ed.
Fundamental Considerations in Gerontology
1. A 78-year-old patient expresses fear about “getting old”
and losing independence. Which statement best reflects
a gerontological principle that the APN should keep in
mind?
A. “Most older adults are depressed about aging.”
B. “Older adults uniformly resist changes in their health
status.”
C. “Older adults’ self-concept is closely tied to their
perceived independence.”
D. “Older adults lack the cognitive ability to participate in
decision-making.”
Answer: C
Rationale: Older adults often value autonomy and
independence highly; threats to these can negatively impact
self-concept. A is incorrect—while some experience sadness,
depression is not universal. B is incorrect—many adapt well to
health changes. D is incorrect—unless cognitive impairment
exists, most can engage in decisions.
2. When planning care for an 82-year-old patient, which
approach best utilizes the concept of “chronological
versus functional age”?
A. Basing treatment solely on the patient’s calendar age.
B. Ignoring the patient’s functional abilities when setting
, goals.
C. Assessing mobility, cognition, and ADLs to guide
interventions.
D. Applying standardized protocols used for all ≥ 80 years
old.
Answer: C
Rationale: Functional age—how well one performs daily
activities—often predicts health more accurately than years
lived. A and D are incorrect—chronological age alone is
insufficient. B is incorrect—functional assessment is essential.
3. An 85-year-old with multiple comorbidities asks about a
new preventive screening. How should the APN decide
whether to recommend it?
A. Order all U.S. Preventive Services Task Force screenings
regardless of life expectancy.
B. Base recommendation on life expectancy, comorbidity
burden, and patient values.
C. Decline any new tests, as further screening is low yield
in advanced age.
D. Follow the patient’s chronological age cutoff strictly.
Answer: B
Rationale: Decision-making should integrate life expectancy,
comorbidities, and patient preferences. A and D ignore
individualization; C overgeneralizes and may deny beneficial
services.
, 4. Which statement most accurately reflects the
“compression of morbidity” concept?
A. Older adults are experiencing more years of chronic
illness.
B. Chronic disease now begins earlier in life.
C. Onset of disability is delayed, with shorter periods of
illness before death.
D. Life expectancy and healthy years are declining.
Answer: C
Rationale: Compression of morbidity refers to reducing the
time a person spends ill or disabled, postponing disability until
late in life. A and B are opposite concepts; D is incorrect—it
actually implies improved healthy years.
5. In teaching a class of community caregivers about
ageism, which example should the APN identify as
ageist?
A. Offering menus in large print to a patient with macular
degeneration.
B. Assuming an 80-year-old cannot learn to use a
smartphone.
C. Encouraging a 75-year-old to walk daily to maintain
strength.
D. Speaking face-to-face in a quiet voice to a
hearing-impaired elder.
Answer: B
Rationale: Assuming incapacity based solely on age reflects
,ageism. A, C, and D are appropriate accommodations or
positive health encouragements.
6. Which factor best exemplifies “successful aging”
according to gerontological theory?
A. Absence of any chronic disease.
B. Maintenance of high cognitive and physical function
despite illnesses.
C. Living beyond 90 years regardless of health status.
D. Complete independence in all activities of daily living.
Answer: B
Rationale: Successful aging emphasizes adaptation, preserved
function, and engagement despite chronic conditions. A is
unrealistic for many older adults. C measures longevity without
quality. D ignores quality of life and support needs.
Normal Physiological Changes With Aging
7. A 70-year-old patient demonstrates an increased systolic
blood pressure but normal diastolic. Which age-related
vascular change explains this?
A. Increased elasticity of arterial walls.
B. Increased peripheral vascular resistance from arterial
stiffening.
C. Decreased sympathetic tone leading to vasodilation.
D. Increased capillary recruitment in muscle beds.
,Answer: B
Rationale: Arterial stiffening increases systolic pressure and
peripheral resistance. A is opposite. C would lower pressure. D
affects microcirculation, not the primary driver.
8. Which renal change is most characteristic of normal
aging?
A. Increased glomerular filtration rate (GFR).
B. Decreased ability to concentrate urine.
C. Reduced serum creatinine despite stable muscle mass.
D. Enhanced tubular reabsorption of sodium.
Answer: B
Rationale: Aging kidneys have reduced concentrating ability,
risking dehydration. A is incorrect—GFR declines. C is
incorrect—serum creatinine often remains stable or slightly
increases given muscle loss. D is incorrect—tubular
reabsorption often declines.
9. An 80-year-old reports difficulty climbing stairs and joint
stiffness. Which musculoskeletal change is most
explanatory?
A. Increased collagen elasticity in tendons.
B. Loss of bone mass and joint cartilage thinning.
C. Hyperplasia of muscle fibers.
D. Increased production of synovial fluid.
Answer: B
Rationale: Aging leads to osteopenia/osteoporosis and articular
,cartilage wear. A and D are opposite. C does not occur—muscle
mass declines.
10. Age-related changes in the respiratory system
include:
A. Increased chest wall compliance.
B. Enhanced alveolar elasticity.
C. Reduced vital capacity and increased residual volume.
D. Increased strength of respiratory muscles.
Answer: C
Rationale: Loss of elastic recoil decreases vital capacity and
raises residual volume. A and B are incorrect—compliance
decreases, elasticity declines. D is incorrect—muscle strength
wanes.
11. Which cognitive change is considered a normal part
of aging?
A. Profound memory loss affecting daily functioning.
B. Slowed processing speed with stable long-term
memory.
C. Rapid decline in vocabulary and language skills.
D. Development of new learning disabilities.
Answer: B
Rationale: Processing speed often slows, but crystallized
intelligence (vocabulary, long-term memory) remains stable. A
and C suggest pathological decline. D is not typical.
, 12. An 85-year-old has reduced thirst sensation. This
reflects age-related changes in:
A. Hypothalamic osmoreceptor sensitivity.
B. Kidney aldosterone secretion.
C. Sweat gland activity.
D. Gastric acid production.
Answer: A
Rationale: Osmoreceptor sensitivity in the hypothalamus
declines, blunting thirst. B, C, and D do not directly mediate
thirst.
13. Regarding skin aging, which finding is most
expected?
A. Increased sebum production leading to oily skin.
B. Thicker epidermis with enhanced wound healing.
C. Loss of dermal collagen and decreased elasticity.
D. Increased melanocyte activity causing
hyperpigmentation uniformly.
Answer: C
Rationale: Dermal collagen declines, causing wrinkling and
decreased elasticity. A and B are opposite. D occurs in
sun-exposed areas but is not uniform.
Interpretation of Laboratory Values Specific to Older Adults
14. An 88-year-old’s serum creatinine is 1.2 mg/dL. How
should the APN interpret this?
Questions for Advanced Practice Nurses
📘 Table of Contents
Unit I: The Healthy Older Adult
1. Changes with Aging
2. Health Promotion
3. Exercise in Older Adults
4. Nutritional Support in the Older Adult
5. Settings of Care (new chapter in this edition)
Unit II: Assessment
6. Comprehensive Geriatric Assessment
7. Symptoms and Syndromes (covers common geriatric
syndromes and their atypical presentations)
Unit III: Treating Disorders
(Returns to system-based chapters with signal-symptoms, SORT
evidence ratings, in-text case studies)
8. Dermatologic Disorders
9. Head, Neck, and Face Disorders
10. Cardiovascular Disorders
11. Respiratory Disorders
12. Peripheral Vascular Disorders
13. Gastrointestinal Disorders
,14. Urologic and Renal Disorders
15. Gynecologic Disorders
16. Musculoskeletal Disorders
17. Central and Peripheral Nervous System Disorders
18. Endocrine and Metabolic Disorders
19. Hematologic Disorders
20. Psychosocial Disorders
Unit IV: Complex Illness
21. Polypharmacy
22. Chronic Illness and the APRN
23. Palliative Care and End-of-Life
,Chapter 1 “Changes With Aging” from Advanced Practice
Nursing in the Care of Older Adults, 3rd Ed.
Fundamental Considerations in Gerontology
1. A 78-year-old patient expresses fear about “getting old”
and losing independence. Which statement best reflects
a gerontological principle that the APN should keep in
mind?
A. “Most older adults are depressed about aging.”
B. “Older adults uniformly resist changes in their health
status.”
C. “Older adults’ self-concept is closely tied to their
perceived independence.”
D. “Older adults lack the cognitive ability to participate in
decision-making.”
Answer: C
Rationale: Older adults often value autonomy and
independence highly; threats to these can negatively impact
self-concept. A is incorrect—while some experience sadness,
depression is not universal. B is incorrect—many adapt well to
health changes. D is incorrect—unless cognitive impairment
exists, most can engage in decisions.
2. When planning care for an 82-year-old patient, which
approach best utilizes the concept of “chronological
versus functional age”?
A. Basing treatment solely on the patient’s calendar age.
B. Ignoring the patient’s functional abilities when setting
, goals.
C. Assessing mobility, cognition, and ADLs to guide
interventions.
D. Applying standardized protocols used for all ≥ 80 years
old.
Answer: C
Rationale: Functional age—how well one performs daily
activities—often predicts health more accurately than years
lived. A and D are incorrect—chronological age alone is
insufficient. B is incorrect—functional assessment is essential.
3. An 85-year-old with multiple comorbidities asks about a
new preventive screening. How should the APN decide
whether to recommend it?
A. Order all U.S. Preventive Services Task Force screenings
regardless of life expectancy.
B. Base recommendation on life expectancy, comorbidity
burden, and patient values.
C. Decline any new tests, as further screening is low yield
in advanced age.
D. Follow the patient’s chronological age cutoff strictly.
Answer: B
Rationale: Decision-making should integrate life expectancy,
comorbidities, and patient preferences. A and D ignore
individualization; C overgeneralizes and may deny beneficial
services.
, 4. Which statement most accurately reflects the
“compression of morbidity” concept?
A. Older adults are experiencing more years of chronic
illness.
B. Chronic disease now begins earlier in life.
C. Onset of disability is delayed, with shorter periods of
illness before death.
D. Life expectancy and healthy years are declining.
Answer: C
Rationale: Compression of morbidity refers to reducing the
time a person spends ill or disabled, postponing disability until
late in life. A and B are opposite concepts; D is incorrect—it
actually implies improved healthy years.
5. In teaching a class of community caregivers about
ageism, which example should the APN identify as
ageist?
A. Offering menus in large print to a patient with macular
degeneration.
B. Assuming an 80-year-old cannot learn to use a
smartphone.
C. Encouraging a 75-year-old to walk daily to maintain
strength.
D. Speaking face-to-face in a quiet voice to a
hearing-impaired elder.
Answer: B
Rationale: Assuming incapacity based solely on age reflects
,ageism. A, C, and D are appropriate accommodations or
positive health encouragements.
6. Which factor best exemplifies “successful aging”
according to gerontological theory?
A. Absence of any chronic disease.
B. Maintenance of high cognitive and physical function
despite illnesses.
C. Living beyond 90 years regardless of health status.
D. Complete independence in all activities of daily living.
Answer: B
Rationale: Successful aging emphasizes adaptation, preserved
function, and engagement despite chronic conditions. A is
unrealistic for many older adults. C measures longevity without
quality. D ignores quality of life and support needs.
Normal Physiological Changes With Aging
7. A 70-year-old patient demonstrates an increased systolic
blood pressure but normal diastolic. Which age-related
vascular change explains this?
A. Increased elasticity of arterial walls.
B. Increased peripheral vascular resistance from arterial
stiffening.
C. Decreased sympathetic tone leading to vasodilation.
D. Increased capillary recruitment in muscle beds.
,Answer: B
Rationale: Arterial stiffening increases systolic pressure and
peripheral resistance. A is opposite. C would lower pressure. D
affects microcirculation, not the primary driver.
8. Which renal change is most characteristic of normal
aging?
A. Increased glomerular filtration rate (GFR).
B. Decreased ability to concentrate urine.
C. Reduced serum creatinine despite stable muscle mass.
D. Enhanced tubular reabsorption of sodium.
Answer: B
Rationale: Aging kidneys have reduced concentrating ability,
risking dehydration. A is incorrect—GFR declines. C is
incorrect—serum creatinine often remains stable or slightly
increases given muscle loss. D is incorrect—tubular
reabsorption often declines.
9. An 80-year-old reports difficulty climbing stairs and joint
stiffness. Which musculoskeletal change is most
explanatory?
A. Increased collagen elasticity in tendons.
B. Loss of bone mass and joint cartilage thinning.
C. Hyperplasia of muscle fibers.
D. Increased production of synovial fluid.
Answer: B
Rationale: Aging leads to osteopenia/osteoporosis and articular
,cartilage wear. A and D are opposite. C does not occur—muscle
mass declines.
10. Age-related changes in the respiratory system
include:
A. Increased chest wall compliance.
B. Enhanced alveolar elasticity.
C. Reduced vital capacity and increased residual volume.
D. Increased strength of respiratory muscles.
Answer: C
Rationale: Loss of elastic recoil decreases vital capacity and
raises residual volume. A and B are incorrect—compliance
decreases, elasticity declines. D is incorrect—muscle strength
wanes.
11. Which cognitive change is considered a normal part
of aging?
A. Profound memory loss affecting daily functioning.
B. Slowed processing speed with stable long-term
memory.
C. Rapid decline in vocabulary and language skills.
D. Development of new learning disabilities.
Answer: B
Rationale: Processing speed often slows, but crystallized
intelligence (vocabulary, long-term memory) remains stable. A
and C suggest pathological decline. D is not typical.
, 12. An 85-year-old has reduced thirst sensation. This
reflects age-related changes in:
A. Hypothalamic osmoreceptor sensitivity.
B. Kidney aldosterone secretion.
C. Sweat gland activity.
D. Gastric acid production.
Answer: A
Rationale: Osmoreceptor sensitivity in the hypothalamus
declines, blunting thirst. B, C, and D do not directly mediate
thirst.
13. Regarding skin aging, which finding is most
expected?
A. Increased sebum production leading to oily skin.
B. Thicker epidermis with enhanced wound healing.
C. Loss of dermal collagen and decreased elasticity.
D. Increased melanocyte activity causing
hyperpigmentation uniformly.
Answer: C
Rationale: Dermal collagen declines, causing wrinkling and
decreased elasticity. A and B are opposite. D occurs in
sun-exposed areas but is not uniform.
Interpretation of Laboratory Values Specific to Older Adults
14. An 88-year-old’s serum creatinine is 1.2 mg/dL. How
should the APN interpret this?
